Contrast-enhanced MR angiography: does a higher relaxivity MR contrast agent permit a reduction of the dose administered for routine vascular imaging applications?

Xing, Xiaoying; Zeng, Xiangzhu; Li, Xuan; Zhao, Qiang; Kirchin, Miles A.; Pirovano, Gianpaolo; Wang, Xiaoying; Li, Yuan; Iezzi, Roberto; Cobelli, Francesco De

doi:10.1007/s11547-014-0434-8

Cited by 7 publications

(5 citation statements)

References 28 publications

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“…In particular, at increasing magnetic field strengths gadolinium R1 relaxivity tends to decrease, hence one might expect a parallel deterioration of image contrast in MRA; however, the increased SNR achieved at higher magnetic field, as well as the improved background suppression due to the higher T1 of extravascular tissues, leads to an overall increase of vascular enhancement after contrast agent injection [22]. Even if the relaxivity of both Gadoteridol and Gadobutrol is negatively affected by the increased field strength, the resulting difference remains similar to what has been reported at 1.5T, with a difference that is not sufficient to significantly influence intravascular enhancement and SNR [6,23,24]. The implications of this study for routine practice may be relevant in terms of cost and convenience, since Gadoteridol is less expensive (around 80 euros per single dose vial) in comparison with Gadobutrol (around 130 euros per single dose vial).…”

Section: Discussionsupporting

confidence: 67%

“…18 carotid arteries were evaluated in the 9 patients in group A (Gadobutrol-enhanced MRA) and 42 carotid arteries were evaluated in the 21 patients in group B (Gadoteridol-enhanced MRA) ( Table 1). The average contrast agent volume administered was 7.3 ± 1.2 ml [6][7][8][9][10] in group A and 14 ± 1.9 ml [11][12][13][14][15][16][17][18] (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

“…Over the last decade, CT-angiography (CTA) and MRangiography (MRA) have attained a cardinal role in the imaging of carotid arteries thanks to their increasing diagnostic reliability [2][3][4][5]. Since the introduction of contrast-enhanced MRA, several gadolinium-based contrast agents (GBCA) have been tested and implemented in clinical practice [6][7][8][9], ranging from standard interstitial molecules to high relaxivity and blood-pool agents [4,9,10]. Currently, however, there is no common consensus as to which contrast medium should be used for MRA.…”

Section: Introductionmentioning

confidence: 99%

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Accuracy of gadoteridol enhanced MR-angiography in the evaluation of carotid artery stenosis

Zaccagna

Sacconi

Saba

et al. 2015

Neurovascular Imaging

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Background: To compare image quality and diagnostic performance of Gadoteridol-enhanced MR angiography (MRA) with Gadobutrol-enhanced MRA in the evaluation of carotid artery stenosis. Methods: MRA was performed in 30 patients with carotid stenosis diagnosed at DUS. Patients were randomly assigned to group A (Gadobutrol-enhanced MRA) or group B (Gadoteridol-enhanced MRA). All examinations were performed with a 3T MR system. Image quality was assessed qualitatively by a 3-grade scale and quantitatively with SNR measurements. Diagnostic performance in the assessment of stenosis, plaque length and morphology was evaluated in the two MRA groups by accuracy calculation and RoC curves analysis using CTA as reference standard. Statistically significant differences in SNR and quality scale were evaluated by the Independent-Samples T Test and Mann-Whitney test, while the Z-statistics was used to compare diagnostic accuracy in the two groups. Results: Image quality was graded adequate to excellent for both GBCAs, without significant differences (p = 0.165). SNR values were not significantly different in group B (Gadoteridol-enhanced MRA) as compared to group A (Gadobutrol-enhanced MRA) (89.32 ± 70.4 vs 81.09 ± 28.38; p = 0.635). Diagnostic accuracy was 94 % for the evaluation of stenosis degree and 94 % for the identification of ulcerated plaques in group A, while it was 93 % for the evaluation of stenosis degree and 76 % for the identification of ulcerated plaques in group B, without statistically significant differences (p = 0.936). Conclusion: No significant difference in terms of image quality and diagnostic accuracy was observed between Gadoteridol-enhanced MRA and Gadobutrol-enhanced MRA in patients undergoing evaluation of carotid stenosis.

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Section: Discussionsupporting

confidence: 67%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Accuracy of gadoteridol enhanced MR-angiography in the evaluation of carotid artery stenosis

Zaccagna

Sacconi

Saba

et al. 2015

Neurovascular Imaging

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“…Previous studies have shown that a single Gd‐BOPTA dose can replace a double Gd‐DTPA dose for several MR applications. Gd‐BOPTA yielded qualitatively and quantitatively comparable diagnostic results compared with full‐dose Gd‐DTPA in several previous studies of the brain, heart, and vascular system …”

Section: Discussionmentioning

confidence: 99%

Feasibility of using half‐dose Gd‐BOPTA for delayed gadolinium‐enhanced MRI of cartilage (dGEMRIC) at the knee, compared with standard‐dose Gd‐DTPA

Rehnitz

Klaan

et al. 2019

Magnetic Resonance Imaging

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Background: We sought to replace full-dose Gd-DTPA with safer and lower-dose contrast agents for delayed gadolinium-enhanced MRI of cartilage (dGEMRIC). Gd-BOPTA has a lower intrinsic nephrogenic systemic fibrosis risk and a 2-fold higher relaxivity at 3T; thus, the contrast agent dose may be halved, further reducing contrast agentdependent risks. Purpose: To compare the feasibility of using half-dose, high-relaxivity Gd-BOPTA vs. standard-dose Gd-DTPA for dGEMRIC. Study Type: Prospective observational study. Subjects: Eleven healthy volunteers (five women, mean age 25.7 years) and 10 patients with knee pain (three women, mean age 36.7 years; nine with chondromalacia). Field Strength/Sequences: 3D T 1 -weighted volumetric breath-hold examination (VIBE) sequence at 3T. Assessment: Knee dGEMRIC was performed twice, first using 0.1 mmol/kg Gd-BOPTA and 4 weeks later using 0.2 mmol/kg Gd-DTPA. Contrast penetration was studied using pre-and 60-120-min postcontrast imaging in volunteers and pre-and 90-min postcontrast imaging in patients. Femoral cartilage lesions were assessed using modified whole-organ MRI scores. Healthy cartilage and partial-thickness lesions were compared using region-of-interest analyses by independent readers. Statistical Tests: Linear mixed-effect-models, area under receiver-operating-characteristic curve (AUC) analysis, intraclass correlation (ICC). Results: In healthy volunteers, Gd-BOPTA and Gd-DTPA T 1 -values did not differ significantly at any timepoint (P = 0.164-0.995). In patients, Gd-BOPTA T 1 -values (743.33 AE 72.015 msec) were higher than Gd-DTPA T 1 -values (681.24 AE 67.635 msec, P = 0.030). Gd-BOPTA and Gd-DTPA detected chondromalacia areas equally well, with significantly lower T 1 -values than in healthy cartilage (P < 0.001) and nonsignificantly different AUCs (0.92 and 0.96, P = 0.27). The absolute decrease in T 1 -values between healthy and pathological cartilage was similar (Gd-BOPTA: 149.59 msec; Gd-DTPA: 149.44 msec, P = 0.99). ICCs were 0.83-0.98 for Gd-BOPTA and 0.80-0.98 for Gd-DTPA. Data Conclusion: Gd-BOPTA might be used at half the Gd-DTPA dose in dGEMRIC, with similar contrast penetration and T 1 -values in healthy cartilage and noninferior detection of cartilage damage. Level of Evidence: 2 Technical Efficacy: Stage 5

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“…In this context, preference to macrocyclic GBCAs and strategies to reduce the injected dose of Gd as far as possible while maintaining good diagnostic performance in CE-MRA have been considered 10 . This can also be facilitated by the use of high-relaxivity MR contrast agents (CAs) 11 . Gadopiclenol, a macrocyclic GBCA, has a 2- to 3-fold higher T1 relaxivity than the marketed GBCAs, maintained at very high field 12 .…”

mentioning

confidence: 99%

Evaluation of the Contrast Enhancement Performance of Gadopiclenol for Magnetic Resonance Angiography in Healthy Rabbits and Pigs

Hugon,

Adriaensen,

Wintrebert

et al. 2024

Invest Radiol

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Objectives Unexpected accumulations of gadolinium in various organs were reported after the administration of gadolinium-based contrast agents, making desirable to reduce the dose while maintaining equivalent diagnostic performance. The aim of this study was to evaluate the contrast enhancement performance of high relaxivity gadopiclenol compared with gadoterate meglumine in abdominal contrast-enhanced magnetic resonance angiography (CE-MRA). Materials and Methods In a first study in healthy rabbits, axial 3D gradient echo sequences were applied at 4.7 T to study arterial enhancement as a function of gadopiclenol dose (0.025, 0.05, 0.075, and 0.1 mmol Gd/kg) or gadoterate meglumine at 0.1 mmol Gd/kg (n = 5–6/group). The increase in signal-to-noise ratio (ΔSNR) in the aorta at the first pass was measured and compared. In a second, crossover study in 6 healthy pigs, abdominal CE-MRA sequences were acquired at 3 T with gadopiclenol at 0.05 mmol Gd/kg or gadoterate meglumine at 0.1 mmol Gd/kg at a 1-week interval. Quantitatively on the maximum intensity projection (MIP) images, the mean MIP SNR within the aorta of both groups was compared. Qualitatively, a blinded comparison of the angiograms was performed by an experienced radiologist to determine the preferred contrast agent. Results In the rabbit, ∆SNR is linearly correlated with the gadopiclenol dose (P = 0.0010). Compared with gadoterate meglumine 0.1 mmol Gd/kg, an increase in the ∆SNR is observed after 0.05, 0.075, and 0.1 mmol Gd/kg of gadopiclenol (+63% P = 0.0731, +78% P = 0.0081, and +72% P = 0.0773, respectively), whereas at 0.025 mmol Gd/kg, ∆SNR is in the same range as with gadoterate meglumine 0.1 mmol Gd/kg (+15% P > 0.9999). In pigs, contrast enhancement after gadopiclenol at 0.05 mmol/kg is +22% superior to MIP SNR after gadoterate meglumine at 0.1 mmol Gd/kg (P = 0.3095). Qualitatively, a preference was shown for gadopiclenol images (3/6) over the gadoterate meglumine examinations (1/6), with no preference being shown for the remainder (2/6). Conclusions First-pass CE-MRA is feasible with gadopiclenol at 0.05 mmol Gd/kg with at least the same arterial signal enhancement and image quality as gadoterate meglumine at 0.1 mmol Gd/kg.

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Contrast-enhanced MR angiography: does a higher relaxivity MR contrast agent permit a reduction of the dose administered for routine vascular imaging applications?

Abstract: Under identical examination conditions a single 0.1 mmol/kg body weight dose of gadobenate dimeglumine can fully replace a double 0.2 mmol/kg body weight dose of gadopentetate dimeglumine for routine CE-MRA procedures.

Cited by 7 publications

References 28 publications

Accuracy of gadoteridol enhanced MR-angiography in the evaluation of carotid artery stenosis

Accuracy of gadoteridol enhanced MR-angiography in the evaluation of carotid artery stenosis

Feasibility of using half‐dose Gd‐BOPTA for delayed gadolinium‐enhanced MRI of cartilage (dGEMRIC) at the knee, compared with standard‐dose Gd‐DTPA

Evaluation of the Contrast Enhancement Performance of Gadopiclenol for Magnetic Resonance Angiography in Healthy Rabbits and Pigs

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